Walsh & Hoyt: Eyelid Retraction

Inappropriate and excessive elevation of the eye lids eyelid retraction makes a patient appear to be staring and also produces an illusion of exophthalmos. Mild degrees of lid retraction are frequently difficult to evaluate. The resting position of the upper lid is influenced by many factors, including age, alertness, and direction of gaze. Normal variations in resting lid position, or upper lid posture, are exemplified by the striking difference between infants and adults. The infants eyelid, which barely touches the upper corneal limbus, may appear normal, whereas a similar lid position in an adult is abnormal and represents excessive lid elevation. In general, upper lid position is abnormal if it exposes sclera between the lid margin and the upper corneal limbus when the patients head is straight and both of the patients eyes are directed straight ahead.